Healthcare Provider Details

I. General information

NPI: 1760853675
Provider Name (Legal Business Name): PAIN SPECIALISTS OF OREGON PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2015
Last Update Date: 12/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 S GARDEN WAY STE 101
EUGENE OR
97401-8173
US

IV. Provider business mailing address

360 S GARDEN WAY STE 101
EUGENE OR
97401-8173
US

V. Phone/Fax

Practice location:
  • Phone: 541-844-1807
  • Fax:
Mailing address:
  • Phone: 541-844-1807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JOSEPH S DUNN
Title or Position: OWNER
Credential: MD
Phone: 541-743-5036